4 ways how to treat your melasma
It is most often seen in middle-aged women: darker areas on the skin, usually on the forehead or temples. The cheeks also show the dark areas, as well as the upper lip and chin. Men are much less affected by this phenomenon. This is a Melasmasometimes referred to as chloasma.
The development of the spots usually takes place over a long period of time. The affected areas of the skin do not itch or cause pain. Basically, they are harmless. Melasma is a mostly chronic skin disease, which leads to blotchy, brown pigment spots on the skin.
This can cause a high level of suffering, especially since the pigment disorder appears for the first time in most cases between the twentieth and fortieth year of life. The good news is that you don’t have to put up with it. Because with modern medical technology, melasma can be treated well. But why do melasma develop in the first place? And how exactly can they be treated?
Factors for the development of melasma
Various aspects are responsible for the Emergence of a melasma decisive. Studies show that people with brown skin are more prone to melasma than people with white or black skin. The development of melasma is subject to complex processes.
In the final analysis, melasma are due to an overproduction of Melanins due to the presence of melanins. Melanins are reddish or black pigments which are responsible for the coloration of our skin, hair and eyes. The production of melanin can be influenced by various internal and external factors.
These include, for example, genetics, hormonal changes, age, inflammation and, of course, strong sun exposure. If melanin is produced in excess in our body, this results in what is known as hyperpigmentation. The result is an uneven coloring of the skin.
The reason for the overproduction of pigment can be genetic predisposition. But there are also other triggers over which we have partial influence. These include the following:
- Solar radiation
- Pregnancy: in most cases melasma disappears a few months after birth
- Hormonal treatments: Birth control pills and hormone replacement treatments.
- Medications: These include new drugs used to treat cancer, deodorizing soaps, toiletries, and cosmetics. Ingredients can trigger phototoxic reactions that cause the development of chronic melasma
About 90 percent of patients affected by melasma are women. Hyperpigmentation is most common in countries with many sunny days and in people who have darker skin, such as inhabitants of Asian countries or Latin America. However, melasma can also occur spontaneously in rare cases, i.e. for no apparent reason. But let’s take a closer look at the individual aspects:
Melasma due to sun exposure
UV rays stimulate pigment cells to produce more melanin. This is also the reason why our skin tans in the sun. If melasma already exists, it becomes even darker in the affected areas. Intensive sun protection with a high sun protection factor can help prevent this.
A visit to the solarium can also have an intensifying effect on hyperpigmentation. Affected patients often notice that melasma darkens even further in summer. In winter, under weaker sunlight, it becomes paler. The dark discolorations of the facial skin are mainly an aesthetic phenomenon, as they are completely harmless from a medical point of view.
Melasma due to pregnancy
Especially in the last trimester of pregnancy, the female sex hormones estrogen and progesterone are produced to a particular extent. This can trigger melasma – or intensify an existing one. Since the brownish discolorations often form like a mask on the forehead, cheeks, upper lip and chin, this is also referred to as the “pregnancy mask”.
However, this often regresses on its own after delivery. With the drop in estrogen levels, melasma that has newly appeared during pregnancy also fades with time. New formation or worsening of the skin disease can be associated with severe fluctuations in estrogen levels in at least a quarter of affected patients.
Melasma due to hormones
The most common trigger for melasma is hormones. In addition to the increased production of female sex hormones during pregnancy, estrogen and progestin in general, in combination with sun exposure, can lead to hyperpigmentation of the skin. Scientists assume that cells that produce pigments are stimulated to produce melanin by female sex hormones – and this happens when the skin is exposed to UV radiation.
Women who use birth control pills also have an increased risk of developing melasma. The same applies to menopausal women undergoing hormone replacement therapy. This is because in both cases, similar changes in hormone balance take place in the female body as during pregnancy. Tumors that produce estrogen can also trigger the disease.
Melasma caused by drugs
In rather rare cases, certain medications trigger the development or intensification of melasma. These are generally drugs that make the skin more sensitive to sunlight. In addition, some chemical substances, herbal juices or various drugs for the long-term treatment of epilepsy as well as certain neuroleptics can lead to melasma.
Melasma due to cosmetics
Melasma is very rarely caused by cosmetics or perfume. Most often, these cases involve products that contain petrolatum, such as skin creams. Substances in skin care products that promote an increase in photosensitivity can also trigger melasma. If the skin is already sensitized, the UV radiation can then even trigger allergic reactions.
Melasma due to genetics
Of course, the genetic predisposition of patients also plays an important role. If there are or have been cases of melasma in the family, the probability of also developing the disease is increased – especially for a woman. This is more often seen in families with a darker skin type than in fair-skinned people. The presence of many moles can also increase the risk of developing melasma.
Hyperpigmentation is also more common in patients suffering from (hereditary) thyroid disorders. This also includes melasma. Doctors suspect a connection here with the thyroid hormone. This is because a high percentage of women who develop melasma during pregnancy also have a thyroid function disorder.
Forms of treatment of a melasma
Various forms of therapy can be used to treat melasma. Depending on whether a melasma extends only into the epidermis or into the dermis, the success of the therapy can differ. This involves various peelings and supportive care. The peelings usually have to be repeated between four and ten times to achieve the desired treatment success.
Path 1: Mechanical peelings – ablation and regeneration
In the course of mechanical peelings, depending on the depth of treatment, the epidermis and parts of the dermis are removed. The skin cells affected by the pigment disorder are then included. The skin is subsequently stimulated to regenerate.
Path 2: Chemical peels – acid for an even skin tone
Chemical peels are very different from each other. Depending on how deep the melasma is present in the skin, deeper peels must be performed. The deeper the skin is treated, the more it is attacked and cells are destroyed and removed. The regeneration of the skin can take several weeks.
In these methods, acidic substances are applied to the affected areas of the skin. With lighter to medium peels, it is quite possible to improve the skin quality without damaging the skin structure. Here, for example, comes a Peeling with fruit acid is possible. When glycolic acid is used in combination with salicylic acid, a significantly deeper result can be achieved.
Path 3: Laser peeling – the gentle method
Modern laser technology is replacing more and more chemical and mechanical peels. The treatment uses CO2 lasers, which heat the water in the skin with infrared radiation. As a result, the water evaporates and leads to vaporization of thin layers of skin.
Path 4: Support of the therapy
In addition to therapy, you can still apply supportive creams and lotions to the skin at home. Moreover, it helps to find out the cause of melasma occurrence. By avoiding sun exposure or certain medications, you can spare your skin and better prevent further pigmentation disorders.
Consistent sun protection with a sunblock is the best support for the therapy that you can do yourself. Normal sun creams are not sufficient here. The solarium must be and remain a taboo. Be patient, because the treatment of melasma can take some time. Dr. Fuchs and his experienced team will accompany you throughout the entire process.
If you have any further questions about melasma and treatment options, or if you would like to have your pigmentation disorders examined, please feel free to contact your Skin Center report. Here you can find out which therapy is best for you and your skin type. Simply contact the competent team of experienced dermatologists around Dr. Fuchs with confidence. You will receive a comprehensive consultation and a recommendation for therapy tailored precisely to your personal situation.